Atrial fibrillation, anticoagulation, fall risk, and outcomes in elderly patients

被引：78

作者：

Sellers, Matthew B. ^{[2
]}

Newby, L. Kristin ^{[1
,2
,3
]}

机构：

[1] Duke Clin Res Inst, Durham, NC 27715 USA

[2] Duke Univ, Med Ctr, Dept Med, Durham, NC 27710 USA

[3] Duke Univ, Med Ctr, Div Cardiol, Durham, NC 27710 USA

来源：

AMERICAN HEART JOURNAL | 2011年 / 161卷 / 02期

关键词：

ANTITHROMBOTIC THERAPY; STROKE PREVENTION; INTRACRANIAL HEMORRHAGE; WARFARIN THERAPY; INTENSITY; ASPIRIN; SEVERITY; DESIGN; COMPLICATIONS; CLOPIDOGREL;

D O I：

10.1016/j.ahj.2010.11.002

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Atrial fibrillation (AF) affects 2.5 million patients in the United States. The incidence of this condition increases with age, such that approximately 5% of people >65 years of age have AF. Because of the lack of organized atrial contraction and thrombus formation in the left atrium, patients with AF are at increased risk of stroke. The estimated risk of stroke among all AF patients is 5% per year. Among patients without mitral stenosis, there is a graded relationship of stroke risk with the number of CHADS(2) risk factors. Warfarin is the recommended treatment for embolic stroke prophylaxis in AF in intermediate-to high-risk patients. However, elderly patients who are deemed to be at risk of falls are often not started on warfarin therapy secondary to a perceived higher risk of bleeding complications. These risks have been evaluated, but conclusive data regarding the risk-benefit trade-off are elusive. This review summarizes available data on the use of warfarin in elderly patients with AF, focusing on the risk of bleeding, and will specifically address the utility of falls risk assessment in the decision to initiate warfarin therapy for AF. (Am Heart J 2011;161:241-6.)

引用

页码：241 / 246

页数：6

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